Alabama Doctor Arrested In Connection with Matt Roberts of 3 Doors Down Overdose Death

In mid-August of this year, fans were stunned by the death of 38-year-old Matt Roberts, former guitarist of 3 Doors Down. Alabama physician Dr. Richard Snellgrove was arrested November 16th for allegedly providing the rocker with drugs outside the course of his professional practice. Snellgrove prescribed some five different medications, including methadone, hydrocodone, lorazepam and fentanyl — all prescribed in the names of different individuals, but intended for Roberts.

Slated to perform at a charity event for veterans, the rocker’s father, Darrell Roberts, who often traveled alongside the star, learned of his son’s death the morning following rehearsals. The elder Roberts was informed his son was “either asleep or passed out in the hallway of his hotel” by authorities. Roberts’ father indicated that his son had been fighting a prescription medication addiction to combat his anxiety since joining the band.

A Serious Issue Beyond Over-Prescription
While Roberts’ father noted that he didn’t have any bitterness or anger toward the doctor, he drew attention to the seriousness of the issue in the medical community across the U.S. Prescription drug abuse causes the largest percentage of deaths from drug overdosing, with opioid painkillers the most common culprit. Roberts is among a string of stars over the past decade, including Prince, Whitney Houston, Michael Jackson, Brittany Murphy, Heath Ledger, and Anna Nicole Smith – alongside thousands of other unnamed “average” Americans – sons, fathers, mothers, daughters, brothers, sisters, and friends – all lost to the prescription drug abuse epidemic sweeping the nation, unheeded by age, race, gender, or income level.

Re-Thinking “the Norm”
In chronic pain treatment, particularly where opioids are concerned, there seems to be a disconnect between a drug’s approval for use and its potential for harm, leading to over-prescription and deadly drug interactions. This is why ANS developed its unique pharmacotherapy review program, the only drug utilization review system in the industry with a hands-on, state by state jurisdictional approach. Sometimes to help an injured worker, “it takes a village”, and the ANS face-to-face collaborative process uses locally based legal nurse experts to bring doctors, patients, insurers, and legal representatives all onto the same page. Other drug utilization processes act superficially and fail to follow up, but the ANS process consistently achieves the most impactful patient outcomes while producing the lowest MSA’s and most improved loss ratio’s in the industry. All this while offering a risk free “No Fee Assurance” guarantee for WC payers who wish to try the program.

To truly improve patient treatment outcomes and stop the opioid epidemic try http://ans-solutions.com/ scientifically-based, cost-effective pharmacotherapy review programs. Contact us today.

Original content posted on http://ans-solutions.com/alabama-doctor-arrested-in-connection-with-matt-roberts-of-3-doors-down-overdose-death/

The Impact of Workers Compensation Compounding

As custom-made compound prescriptions concoctions continue to rack-up higher workers’ compensation costs, insurers are scrambling to find alternatives and employers are looking for relief from equally inflated premiums. With little to no evidence as to the efficacy of such creations, many states have implemented treatment guidelines directing doctors to more evidentiary-based, easily reimbursable options. Despite guidelines and formularies however, loopholes in coverage continue to allow providers to sell millions of dollars of compounds, with many companies submitting inflated reimbursement bills in their attempts to get paid.

A Growing Issue in Workers Compensation

This June, the U.S. Attorney’s Office brought criminal charges against such providers across the country, accusing them of defrauding the Medicare, Medicaid, and Tricare health insurance programs that serve the military and their families. Additionally, the Inspector General of the U.S. Postal Service identified compound drugs as attributable for 34% of the postal service’s prescriptions, and 53% of prescription drug costs in 2015, a rise from 22% and 27% in 2014, respectively. State and federal prosecutors also continue to finger some pharmacies for offering doctor kickbacks in exchange for prescriptions.

Money or medicine?

Industry guidelines point to the use of such compounds as a last resort, accepted in instances where a person is allergic to an ingredient in a drug, or when a liquid version of a commercially available drug is necessary for one who cannot swallow capsules. Some doctors prescribe initially despite these guidelines. The unnecessary prescription of compounds is costing the workers’ comp industry billions annually.

Deep impact

2015 calculations indicate…

• Re-packaged drugs dispensed by physicians cost employers 60% to 300% more than those dispensed at retail pharmacies.
• The average paid per compound drug increased by more than two-thirds from $460.00 to $774.00, though non-compound drugs fell slightly from $113.00 to $108.00.
• The U.S. Postal Service alone spent a whopping $390,000.00 a day for compound drugs in 2015.

Tired of paying more for ineffective treatments?
Proven, more affordable, clinically tested and approved options to compounds do exist. It’s time to find a better way. Discover how to achieve better claims outcomes with ANS Solutions Pharmacotherapy Review. Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/the-impact-of-workers-compensation-compounding/

New FDA Warning: Avoid Prescribing Opioids & Benzos Together

In a recent announcement by the FDA, boxed warning labels will now be required to advise against the utilization of prescription opioid pain medicines alongside benzodiazepines unless no other adequate alternative treatment method exists. Warnings about the risks of combining these two classes of drugs are nothing new. Already required on drug warning labels, additional black box warnings are an effort by the FDA to reach out to those who may have “missed the message.”

Classified as Central Nervous System (CNS) depressants, each drug alone can trigger side effects such as respiratory depression (slowed/labored breathing), coma, and death, the effects of which are enhanced in combination. For clinicians living in the dark, these risks will now be spelled out in the black boxes of 389 different pharmaceuticals. Additionally, opioid painkillers such as oxycodone and benzos like alprazolam (i.e. Xanax®) – even the combination of opioid cough medicines with benzos and other CNS depressants (like alcohol) should be avoided. If the drugs must be used together, clinicians have been advised to warn patients of these risks.

The FDA’s latest measure in battling the nationwide epidemic of prescription opioid abuse, essentially classifies this drug combination in the “last resort” genre. Rates of emergency room visits resulting from the nonmedical use of this combination of drugs has tripled from 2004-2011, with the rates of drug-related deaths following suit. According to the FDA, these rates coincide with a 41% increase in patients prescribed both an opioid and benzo between years 2002-2014. The measure is a win for public health officials from 17 states and territories and 13 cities who petitioned the agency in February to require the boxed warning in an effort to fight the routine but unproven treatment method.

Bridging the gap is possible, however, with the help of clinically proven injury and disability treatments from ANS Solutions. Our expert medical legal nurse consultation services and Pharmacotherapy Review Program get the result patients need – without side effects – protecting and enhancing the quality of life for injured workers, and guarding against the medical and financial risks of unproven treatment methods with scientifically-backed protocols. Are you ready to set out on a new path in worker’s comp injury management? Contact http://www.ans-solutions.com today!

Original content posted on http://ans-solutions.com/new-fda-warning-avoid-prescribing-opioids-benzos-together/

Prescription Drugs and the Workers’ Compensation Arena

The U.S. remains the biggest global consumer of prescription drugs, up from around 76 million in 1991 to nearly 207 million in 2013 however a recent court ruling has called into direct question the prescription practices of physicians nationwide (Volkow).

The occurrence of unnecessary or medically inappropriate prescribing of opioids in pain management is compromising the lives and well-being of injured workers.  There are a number of serious issues concerning the use of opioids in pain management:

• Not cost effective
  Evidence-based reviews are seldom consulted prior to the prescribing of opioids, and a lack of appropriate physician monitoring and/or patient compliance further contributes to longer recovery periods and increased cost.
• Increased drug-drug interactions
  Polypharmacy, the use of 4 or more medications simultaneously with opioids, can result in drug-drug interactions with severe consequences for patient health.
• Risk for Addiction and Abuse
  The highly addictive nature of opioids leads to the necessity of higher doses over time, resulting in cost increase and greater risk of overdose/addiction. .
• Lack of evidence for proven benefit
  Recovery and return to work rates are not improved by the use of opioids in pain treatment. The American Academy of Neurology and a number of states have released product guidelines advising physicians to proceed with caution when initiating opioid therapy for pain or long-term use.

• Dose dependent risks for serious harm
  Physicians and patients are not always properly educated on use and good faith prescription practices and guidelines, including risks of remaining on disability, addiction, drug-drug interactions, and dosages at which death and risk of overdose dramatically increase.

Where do we go from here?
It’s never been more obvious than now that effective pain treatment must focus on the legitimacy and efficacy of treatments, keeping in mind the quality of care and quality of life of injured workers.  At ANS Solutions our pharmacotherapy review program is focused on protecting the injured worker by:

• Better addressing the needs of pain patients with the assessment of treatment programs and help of evidence based reviews.
• Improving recovery times with the proper monitoring and modifications of treatment.

• Reducing the risks associated with common opioid treatment regimens by consolidating and coordinating drug therapies between multiple prescribers, identifying duplicate therapies and excessive dosages, and pointing out alternate medication regimens.

Positive change stems from a comprehensive and economically responsible approach in the treatment of pain in workers compensation claims settlements. To learn more about pharmacotherapy review contact ANS today.

References

Volkow, Nora D. Prescription Opioid and Heroin Abuse, House Committee on Energy and Commerce Subcommittee on Oversight and Investigations. https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/prescription-opioid-heroin-abuse;  April 29, 2014.

Original content posted on: http://ans-solutions.com/prescription-drugs-and-the-workers-compensation-arena/

What’s Trending with California Workers’ Compensation

Though workers’ comp claims frequency is declining, a recently released California hospital report indicates claim severity is on the rise. Obtaining data from 35 hospitals and individual facilities, the Milliman and Keenan Healthcare report sourced more than 3,500 claims for review.

Trends identified in the report:

• A decline in indemnity and medical-only claims, with ALAE costs playing an increasing role in overall claims costs in recent years. More specifically:
  • Higher average costs per indemnity for workers over 30.
  • Lesser average severity of indemnity claims in workers 30 and younger, with payments more likely to be incurred as age increases.
• Over the 10-year period ending in 2014, overall losses per $100 of payroll have remained flat. This cumulative effect is believed due to reform laws enacted during this time, as identified in the report:
  • 2005-2014: Severity per indemnity claim (indemnity, medical, and allocated loss adjustment) rises almost 5.5%.
  • 2003-2004: Drop in claim severity (reform laws enacted during this time).
  • 2003-2008: Indemnity claim frequency declines dramatically.
• Costs per indemnity claim for 2014 accidents has decreased approximately 10% from the previous year.
• Litigated claims showed a significantly higher average claim severity. They contributed to 20% of total claims with indemnity payment, and account for approximately 54% of total incurred losses.
• Cost projections for 2015: $2.20 loss cost per $100 of payroll.

A Balanced Approach to Medical Cost Containment

In California’s complex and ever-changing workers’ comp environment, informed decision-making is essential to safeguarding results. At ANS, we pride ourselves at staying at the forefront of (legal and technological) industry changes to ensure the best possible outcomes for both our clients and injured workers.ANS’s three-staged Pharmacotherapy Review Program ensures economically balanced and appropriate treatment options for injured workers. Our legal nurse experts excel at presenting actionable treatment modification recommendations in clear, written proposals for treating physicians, including recommendations such as:

• Consolidation and coordination of drug therapies between multiple prescribers.
• Consideration of alternate therapies.
• Specification of weaning programs for over-prescribed narcotics.
• Use of generics where applicable.

The end result? A cost effective treatment regimen that simultaneously enhances the quality of care for injured workers. Discover more about this advanced and comprehensive treatment strategy. Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/whats-trending-with-california-workers-compensation/

Why ANS Pharmacotherapy Review is so Effective

The prescription pain medication crisis is taking its toll across the U.S. Costs are extreme, with a broad array of collateral damage fanning out from those effected to families and industries, among the hardest hit, workman’s comp. So extreme are the effects of addictive and deadly prescription opioids, even the Federal Government has taken notice, with the CDC stepping in to release new opioid prescribing best practices earlier this year in hopes of ushering in a new era for an ailing nation. The issue is out in the open. Are you missing out on the opportunity to protect patients and break the pharmaceutical cost cycle with a lackluster pharmaceutical intervention program?

Not all drug utilization review programs are created equal

Traditional pharmaceutical intervention programs often yield poor results. Why? Insufficient “drug evaluations” yield sub-optimal analyses, neglecting to account for patient and prescriber history, co-morbidities, and other important factors. Peer-to-peer, phone-based approaches questioning treatment efficacies have the tendency to put doctors on the defensive or induce feelings of frustration over micro-management. Non-binding, verbal commitments lead to repeated calls regarding the implementation of reduced treatment protocols, and ultimately future “call-dodging.” Settlement dates are then repeatedly pushed out, with poor clinical outcomes resulting.

ANS’s proprietary Pharmacotherapy Review

Pharmacotherapy review processes built on the foundation of the intelligent and intimate collaboration of all vested parties produces superior results. How does ANS’s Pharmacotherapy Review fix what’s broken in the typical pharma intervention system?

• In-depth, in-person collaborations. 
  In-office visits with legal nurse experts featuring evidence-based, patient-centered treatment plans presented in a non-threatening manner increase openness to alternative therapies.
• Clear guidelines.
  Written, signed, collaborative agreements are established within 4-5 weeks, complete with detailed drug utilization changes curtailing costly pharma regimes, keeping all parties accountable and on the same page.
• Patient-centered care.
  Physician-directed care with the interest of the injured patient in-mind, including expert consultation, thorough review of medical history and prescription data, and clinically-proven drug alternatives reduce Payer costs and improve patient quality of life, decreasing the potential for drug related issues such as drug interactions and overdose.
• Friendly follow-ups.
  Doctors work with a dedicated CLO (Clinical Liason Officer) until settlement. Repetition of visits with an established legal nurse builds better relationships, allowing for amiable quarterly follow-ups regarding compliance and treatment evaluations, ensuring proper dosing modifications or weaning of medications.
• Quantifiable impact (& performance guarantee).
  The hard work accomplished by ANS representatives and collaborating parties is seen in post-meeting reporting, showing enhanced clinical and patient outcomes as well as reduced pharmaceutical treatment costs. In fact, ANS proprietary Pharmacotherapy Review program boasts:
  • A success ratio of 94% of all case referrals.
  • Enhanced clinical/patient outcomes.
  • Acceleration of MSA settlements.
  • Average cost reductions of over 25%.
  • Loss ratio reductions from 1-2%.
  • Average first year savings of over $7,000.
  • Average life expectancy savings of greater than $250,000.
  • An average return on investment of 20 to 1.

Tired of using the same procedures and expecting a different outcome?
You won’t get extraordinary results with the average pharmaceutical intervention programs. Redefine success with the help of ANS Solutions Pharmacotherapy Review.

Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/why-ans-pharmacotherapy-review-is-so-effective/

Bipartisan Opioid Abuse Bill

In an effort to reverse the rapidly rising death toll from heroin, prescription drugs, and opioids across the U.S. which has recently risen to surpass automobile accidents as the leading cause of injury-related deaths according to the CDC, legislation has been drafted in a rare bipartisan effort.

The Comprehensive Addiction and Recovery Act (CARA)
Designed to strengthen prescription drug monitoring programs, better trace the diversion of opioid drugs, and increase promotion and access to addiction recovery services, CARA will also open up a variety of prevention and treatment avenues:

• Prevention and education efforts designed to prevent methamphetamine, opioid, and heroin abuse.
• Increased availability of Naloxone, an opioid overdose reversal agent, to first responders and law enforcement personnel.
• Disposal sites for unwanted prescriptions.
• Resources to identify and treat incarcerated individuals suffering opioid-related addiction disorders.

Well On Its Way
The bill has been approved by the House and the Senate, with both parties offering broad support. It is the first time in decades Congress has passed comprehensive addiction legislation, and the first time in history they’ve supported long-term addiction recovery. CARA is now on its way to the President’s desk, where it is expected to be signed into law. Mr. Obama has already requested $1.1 billion in funds toward the fight against opioid addiction.

Taking Action
Do you wish there was something you could do now to help in the fight against the nation’s continually rising opioid epidemic? You don’t have to wait on CARA to start making a difference. ANS Solutions proprietary Pharmacotherapy Review helps curtail costly and potentially dangerous pharmaceutical treatment regimens, ensuring optimal patient outcomes through expert knowledge and evidence-based, alternative treatment methods devised face-to-face with the help of treating doctors. Discover the difference an actionable drug utilization review can make. Contact http://www.ans-solutions.com today.

Original content posted on http://ans-solutions.com/bipartisan-opioid-abuse-bill/

Patient Engagement Encouraged through Prescription Drug Label Enhancements

Upcoming improvements to prescription drug labeling are hoped to positively affect patient care across the board. Intentionally kept in the dark on the ingredients and indications of prescription drugs for well-over 100 years, the healthcare industry is shifting from the past’s blind trust to finally realizing today’s modern paradigm: Engaging patients as active participants in their own healthcare endeavors.
Small Label, Big Impact
Improving the synchronization between in-office care and home care, the FDA’s latest labeling procedures will not only help patients under a physician’s care better understand why each medication is being prescribed, clearly listing indications on each prescription drug product’s label, but offer a vast array of opportunities for the betterment of treatment regimes, helping…
In the understanding of prescription regimens and scheduling.

• Verify each prescription is effective/providing benefits for its intended purpose.
• Reduce confusion following brief or rushed clinic encounters.
• Make the identification of drugs easier to allow for proper use/best practices.
• Reduce the incidence of over-prescription, duplicate or unnecessary medications.
• Keep not only patients, but caregivers, pharmacists, and other treating physicians in-the-know on conditions being treated and desired outcomes.
• Improve safety by reducing prescription or dispensing errors.

The Missing Link
This added information, “knowledge” (dubbed the “sixth” patient right in a recent publication of The New England Journal of Medicine), is bringing to light details which have previously fallen through the cracks in today’s modern world of typically rushed, commonly overcomplicated healthcare regimens. Information critical to the patient’s understanding of why a medication has been prescribed and for what conditions or purposes, allowing for a clearer assessment of efficacy for all involved parties.
Are You Living In The Dark?
At ANS Solutions, we also understand the benefits of synchronicity in patient care. The role this plays in in treatment progression, effectiveness, and quality of life from the treatment of routine health issues to return-to-work programs for injured workers is second-to-none. That’s why our industry standard pharmacotherapy review program focuses on face-to-face collaborative care, built upon the integrative collaboration of all effected parties, from the injured worker to our skilled nurse experts and treating physicians, allowing us to produce the very best outcomes in the business with the latest in clinically-proven treatment regimens.
Healthcare costs and injured workers ailing? Uncover a new era in workers’ comp treatment. Contact http://www.ans-solutions.com today.
Sources:

• http://www.painmedicinenews.com/Web-Only/Article/08-16/Adding-Medication-Purpose-to-Prescription-Drug-Labels-Improves-Patient-Safety/37249/ses=ogst

 Original content posted on http://ans-solutions.com/patient-engagement-encouraged-through-prescription-drug-label-enhancements/

Is Regulation the Answer to Rising Pharma Costs?

National pressure has been building for government regulation on pharmaceutical costs.  A recent poll from the Kaiser Family Foundation found that 72% of Americans think drug costs are unreasonable and demand more transparency from drug companies, especially when it comes to how they set prices.(1) In the face of this discourse, the accountability of pharmaceutical companies has grown as a key focus of recent state and federal regulations.

In the state of Vermont, expensive prescriptions drugs distributed by manufacturers must now justify their exorbitant costs, according to a newly introduced state bill. This new approach, dubbed ‘transparency bills’ stipulates that the information provided by drug makers will be made public, and if they fail to submit, fining will result. It further requires that health insurers provide information to enrollees, potential enrollees, and providers regarding the exchange plans’ drug formularies, including covered drugs, cost-sharing prices, drug tiers, prior authorization, step therapy and utilization management requirements, whose facets are rarely known and understood. Similar measures have also been introduced in other states including California, New York, North Carolina, Oregon, Pennsylvania, Texas, and Virginia.

A debate has been brewing around whether regulation is truly the best solution for pharmaceutical cost containment. Opposing views are camped around the significance of immediate verse long-term effects. Those in opposition raise concerns that such regulation will only produce modest consumer savings while the reduction in pharmaceutical revenues will slow the pace of innovation thus reducing life expectancy and the release of new drugs for future generations. Proponents believe that the benefit of lower prices experienced by consumers now far outweighs these concerns. Influenced by this growing debate, researchers at RAND Corporation examined the impact of drug price regulation in the US. Key findings include(2):

• The regulation of pharmaceutical prices has increased in recent years on a global scale
• Regulation has been seen to reduce pharmaceutical revenues.
• Alternative approaches that reduce consumer costs without affecting pharmaceutical revenues are more likely to benefit current and future generations of consumers.

Ans Solutions specializes in pharmaceutical cost containment that optimizes outcomes for the injured worker while also minimizing financial impact for payers.

Sources

• http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-august-2015/
• http://www.rand.org/pubs/research_briefs/RB9412.html

Original content posted on http://ans-solutions.com/is-regulation-the-answer-to-rising-pharma-costs/

The Importance of a Multifaceted Approach to Medical Cost Containment

The biggest hurdle in workers’ compensation medical cost containment is that the injured worker is not getting better. Even though WC claims have steadily declined over the last decade, medical costs keep rising as do the sub-par outcomes for the patient and the payer. What we are seeing is that the inter-connectivity of many factors is hindering the end goal of optimized outcomes. A multidimensional approach is crucial not only for combatting pharma costs, but also for ensuring optimal outcomes for injured workers.
At the end of the day medical care cost containment is more than finding savings, it’s also about examining the big picture to help identify potential areas of exposure while enhancing the quality of care and life for the injured worker.
How is this achieved?  Each case has to be approached individually to develop a custom tailored strategy. It has to start with well-established face-to-face communication with the physician. Once the line of communication is open, actionable treatment recommendations backed by evidence based clinical data can be implemented.
The industry also needs to focus on protocols that will ensure better outcomes and appropriate treatment for injured workers. Compliance protocols will result in improved outcomes for all stakeholders.
While medical expenses are the most obvious cost driver, the full picture involves much more than the number of medical services and associated expenses. Quality medical care directly impacts the speed and likeliness of the injured worker’s return to work. ANS Solutions understands the true cost of these practices and has taken an innovative approach to medical cost containment strategies.
Offering an innovative plan to assist payers, ANS Solutions’ proprietary Pharmacotherapy Review offers the integral assistance needed to optimize claim outcomes:

• Expert review of cases by legal nurse experts, noting duplicate treatments and unnecessary/ineffective procedures.
• Actionable, evidence-based treatment recommendations discussed via face-to-face meetings with physicians.
• Ongoing compliance management with the help of clinical liason officers.

To learn more visit http://www.ans-solutions.com today!

 Original content posted on http://ans-solutions.com/the-importance-of-a-multifaceted-approach-to-medical-cost-containment/

Examining the Effects of Price-Focused Reform

Workers Compensation Research Institute (WCRI) recently conducted a series of studies aimed at examining the effects that federal and state regulations are having on the reduction of pharma spend. What the industry is seeing is an emerging trend in physician prescription reimbursement that begs the question, is price-focused reform effective?

One particular regulation, enacted to cap prices paid by tying the maximum reimbursement to average whole price (AWP) has left physicians in certain states dispensing new drug strengths and formulations at higher prices in efforts to compensate for lost revenue. AWP is set by the original drug manufacturer, however new strengths/formulations are seen as generic, not repackaged. This technical distinction allows the new “manufacturer” to set a new, much higher, AWP, sidestepping reforms. Highlighted in the report, Physician Dispensing of Higher-Priced New Drug Strengths and Formulation, the muscle relaxant cyclobenzaprine, one of several drugs prescribed in this manner, illustrates the effects of such dispensing practices (sales from the first quarter of 2014, post-reform):

• California
  • Typical 5-10mg dose: $0.38-0.39 per pill
  • New 7.5mg product: $3.01 per pill
  • Prescription increase (in same quarter): 55%
• Florida
  • Typical 5-10mg dose: $1.29-1.75 per pill
  • New 7.5mg product: $4.11 per pill
  • Prescription increase: 49%
• Illinois
  • Typical 5-10mg dose: $1.25-1.55 per pill
  • New 7.5mg product: $3.86 per pill
  • Prescription increase: 22%
• Tennessee
  • Typical 5-10mg dose: $1.08 per pill
  • New 7.5mg product: $3.97 per pill
  • Prescription increase: 19%

How can you reduce large loss claim outcomes in the face of these cost drivers?
This trend is driving up medical costs not just in the workers compensation industry, but in the healthcare industry as a whole. With our proprietary pharmacotherapy review, ANS is able to cut through the red tape and provide our clients with quantifiable results. The results achieved not only lower financial costs, but dramatically improve the quality of life and care for the injured worker.

Get on the road to settlement to day with ANS Solutions.

Original Content posted on http://ans-solutions.com/examining-the-effects-of-price-focused-reform.

How Common is Illegal Drug Use Among Pain Patients?

At the American Pain Society’s 35th Annual Scientific Meeting in Austin, findings were released on the use of illicit substances among chronic pain patients. Of 450,081 patients included in a study by Baltimore-based pain medication monitoring firm Ameritox, 10.4% of urine samples tested positive for the use of at least one illicit substance.

How Many of Those Identified Were Workers Comp Patients?
Workers compensation was the primary payer for 22,525 of the 450,081 patients in the study, conducted between January 2013 and July 2015, which showed the use of illicit substances 8.4% of the time in workers comp patients. The group with the highest level of detection, at 16.4%, was Medicaid patients. The lowest: Medicare at 8.1%. Commercially insured individuals were detected at 8.4%, and patient paid tests at 12.5%, respectively. Of those receiving opioid pain treatment drugs, the use of illicit substances was detected at the following rate:

• For patients prescribed Hydrocodone – 10.9%
• For patients prescribed Codeine – 10.7%
• For patients prescribed Oxymorphone – 8.2%

Risk Mitigation and Pharmacotherapy Review
With the use of highly addictive opioids in the treatment of pain, a lack of utilization and/or awareness of risk mitigation strategies is a common driver for poor outcomes. Often times the potential for addiction or the existence of past drug abuse and even behavior consistent with drug abuse are over looked. When this happens the quality of treatment and life in large loss workers compensations claims are severely compromised while associated treatment costs continue to rise.

At ANS, our highly credentialed Legal nurse consultants develop actionable treatment recommendations to enhance the quality of life of injured workers while also ensuring optimal financial outcomes through:

• Comprehensive, holistic medical records reviews and treatment assessments.
• The identification of at-risk individuals and dangerous or deadly drug interactions.
• Uncovering of unnecessary opioid treatment regimens and baseless dosage increases.
• The recommended use of equally effective, less risky, alternative treatment methods where applicable.
• Compliance protocols for monitoring the usage of habit-forming medications, such as opioids.
• Opioid tapering/weaning programs to curb the risk of opioid addiction.

Improve outcomes and reduce costs with the most effective pharma cost containment strategies in the industry. Contact http://www.ans-solutions.com today.

Content was originally published at  http://ans-solutions.com/how-common-is-illegal-drug-use-among-pain-patients/.

Opioids Still the Top Prescribed Drug in California

Using data derived from the 10.8 million workers comp prescriptions dispensed between January 2005 and December 2014, a recently released report by the California Workers’ Compensation Institute identified opioids as the number one prescribed drug in California’s workers’ compensation system.

Report findings indicate that opioid prescriptions accounted for 27.2% of total prescribed pharmaceuticals. In addition, the average cost of opioid prescriptions rose by 85% from $61 to $113. In comparison, other prescription drugs within the same time frame experienced only a 39% increase, from $94 to $131. The report also indicated the proportion of injured workers prescribed opioids within the first 24 months following injury increased from 22.4% in 2005, to 27.9% in 2010.

Some positive trends were revealed however - in 2014, opioids dispensed to injured workers in the state dropped to 27.2%, from a 2009 peak of 31.9%. Also, the impending implementation of a statewide formulary is expected to contribute to reduced opioid use.

At the end of the day however, opioid use is still excessive. While prescription drug monitoring programs have been a focus of California state regulators, other California Workers’ Compensation Institute studies of utilization review have shown that medical management resources in California have been disproportionately directed to the review of requests for opioids and pain management drugs.

In workers’ compensation pain management, opioids continue to be prescribed in situations where their use may not be entirely appropriate, increasing the patient’s risk of addiction or overdose. ANS’s pharmacotherapy review program has been highly successful in uncovering overprescribing and ineffective management of patient treatment plans not just in California but across the country. The work of our legal nurse experts lays the ground work for pain treatment regimens that reduce the financial costs of large loss claims, while improving quality of care and life for injured workers.

To learn more about are success rate in California, contact ANS Solutions today.

This content was originally posted at http://ans-solutions.com/opioids-still-the-top-prescribed-drug-in-california/

Sources:

Hayes, Steve, Swedlow, Alex. “California Workers’ Compensation Institute: Trends in The USE of Opioids in California’s Workers’ Compensation System,” May 2016.

Putting the Injured Worker First

In the workman’s comp industry, significant effort is put toward breaking the pharmaceutical cost cycle for Payers. As the industry fights for savings, however, injured workers often get lost in the shuffle. The nameless and faceless many among worker’s comp injury statistics are quite removed from the system they rely upon.

Bottom Line Statistics Means Poor Outcomes for Injured Workers

As political pundits fight for special interests, benefit caps are set with no relation to each state’s average weekly wage, ignoring improved wage data and analytical methods that could mend take-home benefits in favor of maintaining the status quo. In addition, research undertaken by the worker’s comp industry often passes over the injured workers themselves, focusing on bottom-line statistics. Typical drug utilization review programs further compound this focus, overlooking patient and prescriber history and offering little to no treatment compliance monitoring, thus yielding poor outcomes for all parties involved.

There is a silver lining however, organizations such as the Workers’ Compensation Research Institute (WCRI), the California Workers’ Compensation Institute, and the National Council for Compensation Insurance are attempting to remove the industry’s blinders with improved studies centered on cost containment and service delivery, offering evidence based data on medications, surgeries and providers in an effort to improve care for patients while curtailing costs.

Ensuring the Best Possible Outcomes

ANS’s Pharmacotherapy Review offers more than clinically-proven drug alternatives that reduce Payers’ costs. Our three pronged approach to claim management is much more comprehensive than the industry standard drug utilization review. Improving the quality of life and care of the injured worker is a driving force behind the development of our proprietary pharmacotherapy review program.

• Focusing on the well-being of the injured worker.
• Consolidating and coordinating drug therapies by multiple prescribers to uncover unnecessary or duplicate treatments.
• Providing alternate therapies with less associated risk factors.
• Uncovering potential risk addiction behaviors.
• Offering weaning programs to help combat the over-prescription of narcotics (opioids).

Embrace change for the betterment of all. Find out more about our innovative drug utilization program today by visiting www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/putting-the-injured-worker-first/

CDC Opioid Guidelines Sheds Light on Conflicting Expert Opinions

The CDCs latest opioid prescribing guidelines, released this March, were created with the goal of achieving balance between the analgesic and addictive properties of opioid analgesics, to uphold the safety as well as meet the pain management needs of the public at large. Unfortunately, the controversy surrounding these guidelines points to a detrimental issue at the crux of their implementation: A fractured field – two expert, yet conflicting, schools of thought on the current opioid policy.

• Treating chronic pain with a wider range of treatments, as opposed to relying mainly on opioid regimens.
• Avoiding the use of high dose prescriptions, as well as the combined prescription of opioids and benzodiazepines, to reduce the risk of overdose.
• Providing addiction treatment when necessary (methadone, buprenorphine).

There are two conflicting schools of thought regarding treatment approaches to opioids…

1. Reduce Pain and Suffering.
   This paradigm stems from an aggressive movement in the 1990s wherein physicians trained in pain management and palliative care were instructed to be sympathetic to pain. Enforced by the belief that those in true pain would not become addicted and reinforced by pharmaceutical companies and federal agencies pointing to pain as “the fifth vital sign,” this movement missed the boat on understanding the serious risks of opioid addiction.
2. Prevent and Treat Addiction.
   Driven by addiction specialists, who lacked an understanding of the seriousness of debilitating and chronic pain and whose priorities were vastly different than pain and palliative care physicians, practitioners of this model had a more thorough understanding of the addictive risks of opioid regimens. They watched the sales of opioid prescriptions quadruple from 1999-2010 - alongside the rate of overdose deaths. Though the need for a rapid public health response remained apparent, insufficient evidence on safe stoppage procedures for opioid regimens existed. Dissention among experts as to the seriousness of the problem and how to address also further muddied the waters.

The Fulcrum between Analgesia and Addiction

Though the CDC’s recently released guidelines are as strong as they can currently be, opioid pain treatment regimens – and addiction treatments – continue to be a work in progress. The fractured nature of this field reflects the reason changes were such a long time coming. A multidisciplinary approach will be as essential to working out the kinks as they were to the development of the CDC’s recently released guidelines, as all parties involved strive to save lives and ensure quality of care.

Are you looking for more advanced and comprehensive medical cost containment strategies that protect patient outcomes while also reducing the costs associated with pain management in workers compensation claims? ANS Solutions’ pharmacotherapy review program can help.

This content was originally posted at http://ans-solutions.com/cdc-opioid-guidelines-sheds-light-on-conflicting-expert-opinions/

Key Takeaways from a Recent National Safety Council Survey

Subsequent to the CDC’s new guidelines regarding the treatment of chronic pain, The National Safety Council (NSC) released its latest survey regarding doctor prescribing practices. Summarized below, the statistics:

CDC Guidelines: Use non-opioid therapies first.
NSC Stats: 74% of doctors erroneously believe opioids (morphine, oxycodone) are the most effective way to treat pain.

The Missing Link: Research shows OTC pain meds (ibuprofen, acetaminophen) offer the most effective relief for acute pain.

CDC Guidelines: Do not use opioids for the routine treatment of chronic pain.
NSC Stats: 67% of doctors base there prescribing practices – in part – on patient expectations.

The Missing Link: Patients are often unaware – and doctors wary to inform them – of the effectiveness of alternative treatments for pain. 50% of those patients would return to those prescribers offering alternative treatment.

CDC Guidelines: No longer than 3 days of opioid treatment, beginning with the lowest effective dose.
NSC Stats: 99% of doctors are prescribing these highly addictive drugs for longer than the CDCs recommended time frame – 23% for at least a month.
The Missing Link: Though doctors have the best interests of patients at heart, additional education and training on effective pain management are integral to curbing the rising opioid epidemic.

CDC Guidelines: Address harms of opioid use and assess risk for abuse prior to opioid therapy.
NSC Stats: 84% screen for abuse.
The Missing Link: Only 32% screen for a family history of addiction – a strong indicator.

CDC Guidelines: Re-evaluate risks of continued therapy regularly.
NSC Stats: 99% of doctors have seen a pill-seeking patient – only 32% refer pill-seekers to treatment.
The Missing Link(s): 88% of doctors find referrals overly difficult due to patient unwillingness to cooperate, lack of insurance coverage for such treatments, long wait lists, or lack of providers.

Actionable Treatment Recommendations

ANS's Pharmacotherapy Review Program employs a three staged approach to ensure economically balanced and appropriate treatment options for injured workers. Our legal nurse experts are able to present actionable treatment modification recommendations in a written proposal to treating physicians. Key items of interest covered through the recommendations include:

• Consolidation and coordination of drug therapies between multiple prescribers.
• Consideration of alternate therapies.
• Specification of weaning programs for over-prescribed narcotics.
• Use of generics where applicable.

The end result is a cost effective treatment regimen that simultaneously enhances the quality of care for injured workers. To find out more contact ANS today.

This content was originally posted at http://ans-solutions.com/key-takeaways-from-a-recent-national-safety-council-survey/

Prescription Drug Abuse Knows No Bounds

Earlier this month, the American public was shocked by the untimely death of iconic pop legend Prince. Though autopsy results remain unreported, media coverage alleges that Prince was struggling with a prescription pill addiction to Percocet, receiving treatment for an opioid overdose just days before his death.

This post is not to re-hash celebrity news from various gossip reports but rather to point out the depth and breadth of the prescription drug epidemic. In the past decade, Whitney Houston, Heath Ledger, Brittany Murphy, Anna Nicole Smith and Michael Jackson were just a few other celebrities to overdose on legally prescribed medication. These very public deaths reflect a larger wave of prescription drug abuse across the United States, something ANS has touched on frequently in our blog posts.

A Proactive Approach to Patient Care

There seems to be a false sense of security that accompanies the use of doctor prescribed pain killers- the risk of addiction may not be stated clearly enough or is just not taken seriously.

At the end of the day opioid addiction knows no boundaries, spanning all races, ages, genders and income levels.

When it comes to chronic pain treatment, a focus on the education of well-being of the injured worker is crucial. That is why ANS developed pharmacotherapy review – not only as a medical cost containment strategy for payers, but as a proactive approach to minimizing inappropriate, duplicate or unnecessary treatment regimens, as is often seen with opioid based prescription pain killer treatment regimens.

Through in-depth reviews of each patient’s medical history alongside the assessment of the practices of prescribing physicians, our legal nurse experts are able to uncover underlying illnesses, behaviors and risks, and then implement actionable recommendations to existing treatment plans, addressing potential issues before they can lead to serious adverse events.

Concerned about the growing opioid epidemic and how it’s contributing to treatment outcomes and your large loss workman’s comp claims? We can help, contact ANS today at www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/prescription-drug-abuse-knows-no-bounds/

Effective Pharma Management Can Help Offset Increases in Prescription Costs

2015 saw rising drug prices contributing to the growth in pharmacy spending for American workers’ compensation payers. Meanwhile, opioid and compound drug cost management continues to be an Achilles heel. An effective pharma cost management program can offset these costs by aiming to improve pain treatment regimens for injured workers.

Pharmacotherapy Review Can Reduce Opioid Spend

Opioids continue to be the costliest class of medications for occupational injuries. To combat the rise in opioid utilization in chronic pain treatment of injured workers, ANS introduced a face-to-face and highly proactive approach to addressing pain physician prescribing practices.  Known as Pharmacotherapy review, it starts with an extensive review of the injured workers’ medical history along with their existing pain treatment regimen and historical physician treatment practices. An ANS Legal Nurse expert with intimate case familiarity visits the doctor in person at their office and negotiates an evidence supported pharmacy regime in a face-to-face and collaborative interaction. The treatment recommendations agreed to during this process not only contribute to reduced opioid prescriptions but often enhance the quality of care and life for injured workers with more risk averse and often more appropriate treatment alternatives.

Combating Rising Compounded Medication Costs

In 2015, the average cost for payers of compounded medications per prescription hovered around $2,000. The cost is high and so are the risks to patients:

• Compounded drugs are not federally regulated and product quality assessments are lacking unlike their FDA-approved counterparts.
• Compounded drugs are not clinically evaluated for safety or efficacy.
• Compounded preparations do not have standard product labeling or prescribing information with instructions for safe use.
• Compounding pharmacies are not required to report adverse events to the FDA
• Potential errors in the preparation of compounded drugs can and have caused adverse effects on patients.

Due to the unnecessary risks compounded drugs pose to patients these products are not considered first-line therapies in the treatment of injured workers. ANS Solutions leads the way in providing medical cost containment strategies that help our clients ensure that pain treatment therapies are appropriate, safe and economically responsibly. By managing compounded medications, clients can reduce unnecessary costs and mitigate the potential harmful effects to patient safety caused by pain physician prescribing habits.

Optimized Financial and Patient Outcomes

ANS medical cost containment programs work uniquely to address these and other legal issues that ensure the most rapid and cost reduced settlement of claims in the industry. Our proven strategies are so effective we offer a 1 million dollar pilot program performance guarantee, completely risk free.  To learn more contact us today or visit www.ans-solutions.com.

 

This content was originally published at http://ans-solutions.com/effective-pharma-management-can-help-offset-increases-in-prescription-costs/

2016 WCRI Annual Issues & Research Conference

ANS recently attended the 2016 WCRI Annual Issues & Research Conference. The independent, not-for-profit institute studies and delivers objective information pertaining to public policy issues involving the workers’ comp system.

Conference Panel Highlights:

• Opioid Prescribing in Workers’ Comp
  • Overview:
    Opioids are a societal problem – not just a workers’ comp issue, and it will take a decade to dig ourselves out. Guidelines are necessary to combat the growing trend.
  • Positive Trends:
    Prescription frequency varies widely by state, leading to revised prescribing guidelines in medical/workers’ comp communities. Retail pharmacies are no longer simply filling, but verifying diagnosis/necessity. The DEA/FDA are also reclassifying some medications to reflect abuse potential, and activist groups supporting change are emerging.
  • Negative Trends:
    A major problem in the workers’ comp arena, the need for early intervention/monitoring is being overlooked by employers, and subsequently programs. Conflicting guidelines also cause confusion. Additionally, use of heroin, the cheaper alternative to prescription opioids, is on the rise.
  • Goals:
    Curtail chronic opioid use and ensure appropriate prescribing of opioids to injured workers and avoid unintended results by boosting awareness of the issue.
• Opioid Dispensing and Use
  • Overview:
    Yet-to-be published studies reveal the impact of pricing reforms for opioid dispensing physicians.
  • Physician Dispensing:
    Following reforms, prices decreased in most states, with fewer prescriptions dispensed. In IL and FL prices substantially increased – because physicians switched to formulations not covered in fee schedules. Price/amounts of pharmacy-dispensed products remained constant.
  • Variations in Use:
    Three-of-four injured workers nationwide receive opioids for pain. LA, NY, and PA dispense significantly higher amounts; NY and PA higher dosages. Patients who received opioids also received benzodiazepines in WI, MI, CT and MA. Per claim amounts decreased from 2012-2014, and frequency of drug testing increased significantly.

As an industry leader in large loss workers compensation claim management, ANS is setting the pace for drug utilization review with our proprietary Pharmacotherapy Review, helping fight the trend of the over-prescription of narcotics. Contact http://www.ans-solutions.com today.

This blog was originally posted at http://ans-solutions.com/2016-wcri-annual-issues-research-conference/

FDA Focuses on Opioid Policy

The FDA has recently acknowledged its own need to establish a “far-reaching action plan to reassess the agency’s approach to opioid medications” in order to reduce the trend, deemed by the U.S. Department of Health and Human Services as “a serious public health issue.” Now the leading cause of accidental death in the U.S., more Americans currently die from drug overdoses annually than motor vehicle crashes, the majority of which can be linked back to opioid prescription medications such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.

National Attention

In addition to spurring the FDA to action, Health and Human Services Secretary Sylvia Burwell identified the boundlessness of the epidemic, citing the importance of both state and federal leaders coming together to form “a coordinated and comprehensive approach to address this crisis.” President Obama has also taken part in multiple efforts to curb the issue, including his 2010 National Drug Control Strategy to address opioid use disorders and overdose, as well as an October 2015 Memorandum to Federal Departments and Agencies calling for improved prescriber training and improved access to treatment for those addicted.

Recent Court Cases Press the Issue

The limelight on opioids has also triggered debate in the political arena, as well as even deeper scrutiny by the medical and workers’ comp communities, particularly following an array of eye-opening court cases in which doctors are being held liable for opioid prescribing practices. The most recent? February 2016’s Tseng Conviction, in which a California general practitioner was sentenced 30 years to life for the prescription of unnecessary painkillers which contributed to the fatal overdose of three patients.

The FDA Proposal to Combat the Epidemic

In response to the crisis, the FDA “has developed a comprehensive action plan to take concrete steps toward reducing the impact of opioid abuse on American families and communities.” Among the steps being taken…

• Advisory committees to review new drug applications, especially for opioids without abuse-deterrent properties.
• New warnings and safety labels to help doctors better understand risks and safe prescription practices.
• Upholding new requirements for drug companies to provide new data on the long-term impact of opioid drugs.
• Improved and updated CME training, including proven uses for opioids and safe prescribing practices, to decrease inappropriate prescriptions.
• Creating/expanding access to abuse-deterrent opioid formulations (ADF) to discourage abuse by spurring innovation, as well as generic formulations, of ADF products.
• A re-examination of the risk-benefit paradigm for opioids to include consideration of the widespread public health effects of drugs.

ANS Pharmacotherapy Review

Our approach to pharma review and intervention is the only face-to-face program of its kind offering evidence-based and actionable treatment recommendations that reduce pharma spend while offering improved quality of care for the injured worker with reduced risk of overdose and addiction. Contact http://www.ans-solutions.com to learn more about our comprehensive pharma review and intervention programs today.

This content was originally posted at http://ans-solutions.com/fda-focuses-on-opioid-policy/

SOURCES:

http://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioid-epidemic/

http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

https://www.whitehouse.gov/the-press-office/2015/10/21/fact-sheet-obama-administration-announces-public-and-private-sector

http://www.hhs.gov/about/news/2015/09/17/hhs-hosts-50-state-convening-focused-preventing-opioid-overdose-and-opioid-use-disorder.html#

http://www.fda.gov/NewsEvents/Newsroom/FactSheets/ucm484714.htm

http://nationalpainreport.com/commentary-the-debate-over-opioids-should-be-much-more-than-it-is-8829446.html

http://www.consumerreports.org/cro/magazine/2014/09/the-dangers-of-painkillers/index.htm